Question

Carrie Williams has been admitted to the Psychiatric Unit at Bayshores Treatment Facility. She is eight-and-one-half months pregnant and in a manic state. She has not slept for three days, is hyperactive and hypervoluble. When you come on duty, she is running all over the Day Room, jumping from chairs and standing on tables saying to everyone: "I am Cicely Tyson and I will perform for you. My agent wants you to listen to me and come to see my movies. I'm going to Hollywood and if you treat me right I will take you along."

Along with several other nurses, you decide the patient must be placed in seclusion for her protection and the safety of the fetus. Also, she is disrupting the Unit and upsetting the other patients. Tension in the Day Room is very high as Mrs. Williams climbs over the back of a sofa and almost falls over a table.

After being placed in seclusion, the patient rolls on the floor and bounces herself off the walls with her protruding stomach. The psychiatrist is notified and orders that liquid Haldol (an appropriate dosage for the patient) be injected into the patient's sealed juice containers and that she be encouraged to drink the juice. As the nurse working with this patient you would:

QUESTIONS:

1.            Call the Patient's Rights Advocate since this patient's mental health rights are being violated.

2 Tell the physician if he wants the medication injected into the patient's juice without her knowledge - he can do it.

Answer 1

1st Answer: Everyone with mental illnesses has the right to live, work, and receive treatment in the community, as far as possible. For involuntary patients, every effort should be made to inform the patient about treatment.

In this case Carrie Williams behaviour is involuntary however still efforts should be made to inform her about her treatment, her condition and the health of the her fetus. She should be made to understand that she needs to cooperate with the nurses for her treatment. She should also be informed that the psychiatrist has prescribed liquid Haldol as the part of her treatment. No drug should be given to the patient without their consent or knowledge. So we have to call the patient's rights advocate since the rights of the patient are being violated.

2nd Answer: Since you are a nurse and you know your duties and responsibilities and also the rights of a patient you can tell the psychiatrist that he / she could administer the drug upon the consent of the patient. If he / she administers the drug without patient consent you would have to inform the patient's rights advocate. As the patient is involuntary, would have to inform the patient's rights advocate and then administer the drug to the patient.